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Medication side effect, benign or serious????
I am a 2nd year med student & abt 2-3 years ago, I began to have cont. chest discomfort (loct. mainly on the lft-side of my chest, below my nipple line) w/periodic lft arm tingling & shoulder pain. An ER phys. dx GERD. But the sxms cont., so a phys. ordered a stress test, CT scan, and echo. All tests were nrml except the echo: mild atrioventricular wall motion abnormality of the LV w/a red. in EF 40 - 45% (Final dx: mild LV hypokinesis w/red. of EF of 40-45%). An arteriogram was performed & was told I was in excellent CV health. The doc thought that my sxms and echo were due to my ADHD med (Adderall). I informed my psych doc of my dx & was told my current med regime (20mg bid) was in my best interest & that my sxms may be related to the med but not to worry (Easy for him to say, over 1yr and my sxms cont!!). I know that isolated reports of "CM after chronic use" is ***. w/Adderall & the med is considered a indirect sympathomimetic (which can be ***. w/chest tightness). W/concerns & confuses me is the abnml findings on my echo but normal findings on the arteriogram. Therefore I have several ?'s:(1)Isn't the echo considered the
I am still to be diagnosed also and have had this problem for the last 5 months 11 episodes of heart racing upto 200bpm was described as sinus tachycardia. And constant runs of biggemini, trigemini and what i think is NSVT unfortunatley i live in Wales and havent managed to get any help what so ever. Every single day i feel dizzy, fatigued, blurry vission, headaches. Also on BB which decreases the number of pvcs for me but only if im stationary if i start to move about they return in high frequency which has made me bed ridden anyone else had a similar situation.
Hi,
I don't think you misread me. The very first time I was monitored for PVCs when I was 30 years old, the frequency was 450/hr. Echo was good, stress ekg was good. Cardiologist said BB were first line of treatment. But for a person with normal HR and BP he didn't recommend BB because they might not CHANGE the frequency at all, and might make the frequency worse.
I have read many, many, many posts where people with PVCs took BB and had a great result, I've also read many where people didn't have so good a result. Or had to swithc and switch and switch. I am reluctant to feel like a yo-yo. I really trust the first and only cardiologist I've had, so I'm hesitant to take BB. As a matter of fact, I have been plagued by anxiety for years and years also, and have always taken xanax as needed. It really helped. But recently, even at only .12mg as needed, when I went into NSVT and couplets, I stopped xanax because that could cause an irregular heartbeat. I do try to eliminate EVERYTHING that might be a cause.
That all being said, I had such a terrible few days last week that I broke down and took HALF of the suggested 25mg of Toperol for three days and I think I went out of the NSVT and couplets that I had been experiencing. I also felt totally wigged out, dizzy, tired, and my blood pressure was all over the place. So I've been off the toperol for two days, feel like myself again, and so far the PVCs are just bigeminy or every 10 to 20 beats, which feels like heaven compared to the couplets and NSVT.
Constant afib would be horrible. I must remember there are other people here with some very different rhythms and health conditions that make mine look like a walk in the park. But I'm glad we all share our experience because it REALLY helps. You all have such good information. Thanks
I don't think you misread me. The very first time I was monitored for PVCs when I was 30 years old, the frequency was 450/hr. Echo was good, stress ekg was good. Cardiologist said BB were first line of treatment. But for a person with normal HR and BP he didn't recommend BB because they might not CHANGE the frequency at all, and might make the frequency worse.
I have read many, many, many posts where people with PVCs took BB and had a great result, I've also read many where people didn't have so good a result. Or had to swithc and switch and switch. I am reluctant to feel like a yo-yo. I really trust the first and only cardiologist I've had, so I'm hesitant to take BB. As a matter of fact, I have been plagued by anxiety for years and years also, and have always taken xanax as needed. It really helped. But recently, even at only .12mg as needed, when I went into NSVT and couplets, I stopped xanax because that could cause an irregular heartbeat. I do try to eliminate EVERYTHING that might be a cause.
That all being said, I had such a terrible few days last week that I broke down and took HALF of the suggested 25mg of Toperol for three days and I think I went out of the NSVT and couplets that I had been experiencing. I also felt totally wigged out, dizzy, tired, and my blood pressure was all over the place. So I've been off the toperol for two days, feel like myself again, and so far the PVCs are just bigeminy or every 10 to 20 beats, which feels like heaven compared to the couplets and NSVT.
Constant afib would be horrible. I must remember there are other people here with some very different rhythms and health conditions that make mine look like a walk in the park. But I'm glad we all share our experience because it REALLY helps. You all have such good information. Thanks
I'm not "don't like to take meds". I'll be very good behave and take my medication constantly if it works. I prefer to take medication rather to have surgery! The medication is not working, my heart is still like the train on the track (either "train stop all stations" or "express train"). The side effect drop in and call "hello". It is really a pain from the head to the legs!!!!!!
I hope you all understand. Sorry......
Pika.
I hope you all understand. Sorry......
Pika.
Hi... Pika, sorry, I missed a question or two... by constant afib, I really mean constant, every beat is afib. Oh yeah, I take coumadin... My afib is actually a consequence of mitral valve disease. I had the valve replaced but the afib developed and became an ongoing problem.
I have heard that some people tolerate afib well for a long time... but it probably depends on other factors whether or not it is safe for them to live in a fib. I also heard that people feel better in sinus rhythm, and I would have to say I'm one of them. I'm sorry you don't like to take the meds -- can't blame you really, but it is best to find out whether you are really putting yourself at terrible risk by not taking... or just mild risk. Maybe you don't have afib that often? Anyway, at least your pacer may help keep the afib in check.
Upbeat, I think I misread you about the pvcs -- certainly they are different from the afib, but I just meant it was okay to take bbs with normal bp and hr... don't know how the bbs affect pvcs really, although I didn't notice an increase -- mine are about 3000/24 hr. I took bbs long before I had the afib problem... Propanolol, Nadolol, Toprol... now Sotalol. I think you could request a copy of the stress echo results. I think you have a legal right to them, and you could find out more than they are telling you. I hope you get the rate of pvcs and other arrhythmias down. No caffeine, no alcohol, no spicy food... prob you have tried all that. Have you posted here to ask what the ccf thinks? Maybe if you got the echo results, you could post them... ask for their interpretation. I know some people take low dose atenalol for pvcs... shouldn't think it would hurt to try for a brief time.
Doc2b, Sorry about your predicament. I find that is so often the case: irony in medicine. Maybe try a second psych opinion from someone that has good rep for med knowledge... Thanks for all the afib info -- really interesting. I have a question: did you get an ef reading from the arteriogram (is that the same as a cath?)? If so, was it improved at all? I heard that the ef from an echo is plus/minus 5% accuracy. Where that figure came from, I don't know... Good luck with everything. Maybe you will go in to cardiology. That is the best aspect of having ht diseaxe: it's interesting! :)
Emj
I have heard that some people tolerate afib well for a long time... but it probably depends on other factors whether or not it is safe for them to live in a fib. I also heard that people feel better in sinus rhythm, and I would have to say I'm one of them. I'm sorry you don't like to take the meds -- can't blame you really, but it is best to find out whether you are really putting yourself at terrible risk by not taking... or just mild risk. Maybe you don't have afib that often? Anyway, at least your pacer may help keep the afib in check.
Upbeat, I think I misread you about the pvcs -- certainly they are different from the afib, but I just meant it was okay to take bbs with normal bp and hr... don't know how the bbs affect pvcs really, although I didn't notice an increase -- mine are about 3000/24 hr. I took bbs long before I had the afib problem... Propanolol, Nadolol, Toprol... now Sotalol. I think you could request a copy of the stress echo results. I think you have a legal right to them, and you could find out more than they are telling you. I hope you get the rate of pvcs and other arrhythmias down. No caffeine, no alcohol, no spicy food... prob you have tried all that. Have you posted here to ask what the ccf thinks? Maybe if you got the echo results, you could post them... ask for their interpretation. I know some people take low dose atenalol for pvcs... shouldn't think it would hurt to try for a brief time.
Doc2b, Sorry about your predicament. I find that is so often the case: irony in medicine. Maybe try a second psych opinion from someone that has good rep for med knowledge... Thanks for all the afib info -- really interesting. I have a question: did you get an ef reading from the arteriogram (is that the same as a cath?)? If so, was it improved at all? I heard that the ef from an echo is plus/minus 5% accuracy. Where that figure came from, I don't know... Good luck with everything. Maybe you will go in to cardiology. That is the best aspect of having ht diseaxe: it's interesting! :)
Emj
Emmaj
Hi Emmaj,
You don't have to take blood thinner? Do you have WPW Syndrome? As I know of those have WPW, their A Fib more likely can travel to Ventricle. I'm very confused, about the normal healthy AV node can conduct A Fib into V Fib too.
Do you know, if A Fib didn't take medication what'll happen? (That's me) If I take, my chest like the "train stop all stations" never ending. Now my chest getting start vibrations! I think I dropped my heart someway! I want back my healthy heart!!!!!
Pika.
You don't have to take blood thinner? Do you have WPW Syndrome? As I know of those have WPW, their A Fib more likely can travel to Ventricle. I'm very confused, about the normal healthy AV node can conduct A Fib into V Fib too.
Do you know, if A Fib didn't take medication what'll happen? (That's me) If I take, my chest like the "train stop all stations" never ending. Now my chest getting start vibrations! I think I dropped my heart someway! I want back my healthy heart!!!!!
Pika.
Hi Pika,
It isn't always true that constant afib causes acute heart failure... As it was explained to me, it depends on how healthy a person's av node is. Mine is really healthy, so when I was in constant afib, it was allowing all the electrical signals to get through to the ventricles, and the left ventricle couldn't keep up with the signals... telling it to pump, pump, pump... so the blood started backing up into my venous system causing the heart failure... my neck vein (jugular) had a distension of 10+... and my ef dropped to 25. Had the medication (or some people are cardioverted as a first line of action) not worked, I might have been a candidate for ablation of the pulmonary vein (only done at major med centers), and if I wasn't a candidate for that or if it was unsuccessful, the last recourse would have been to destroy my av node. Then a person becomes totally dependent on the pacer, as the ventricle has no signals from the av node... just from the pacer. I was told that for many people, as they age, their av nodes age too and are not very efficient, which works to their advantage if they develop a problem with chronic afib... Sorry you have not had luck with the meds. I can't take amiodarone (which I'm not sorry about, as it has some long-term dangerous side effects), but I tolerated Sotalol (Betapace). It stopped working for me after a while though, but when the docs added Cardizem, a cc blocker, the afib did pretty much stop. I wanted to stop the Sotalol then, but I was told that the combination of the two meds was the right "cocktail" for me... There is another med, Tykosin, which was discussed as a possibility for controling it. Take care, and hope this has helped some! Emj
It isn't always true that constant afib causes acute heart failure... As it was explained to me, it depends on how healthy a person's av node is. Mine is really healthy, so when I was in constant afib, it was allowing all the electrical signals to get through to the ventricles, and the left ventricle couldn't keep up with the signals... telling it to pump, pump, pump... so the blood started backing up into my venous system causing the heart failure... my neck vein (jugular) had a distension of 10+... and my ef dropped to 25. Had the medication (or some people are cardioverted as a first line of action) not worked, I might have been a candidate for ablation of the pulmonary vein (only done at major med centers), and if I wasn't a candidate for that or if it was unsuccessful, the last recourse would have been to destroy my av node. Then a person becomes totally dependent on the pacer, as the ventricle has no signals from the av node... just from the pacer. I was told that for many people, as they age, their av nodes age too and are not very efficient, which works to their advantage if they develop a problem with chronic afib... Sorry you have not had luck with the meds. I can't take amiodarone (which I'm not sorry about, as it has some long-term dangerous side effects), but I tolerated Sotalol (Betapace). It stopped working for me after a while though, but when the docs added Cardizem, a cc blocker, the afib did pretty much stop. I wanted to stop the Sotalol then, but I was told that the combination of the two meds was the right "cocktail" for me... There is another med, Tykosin, which was discussed as a possibility for controling it. Take care, and hope this has helped some! Emj
Is that constant A Fib will cause heart failure? I heard A Fib will cause Stroke but I never know it can cause heart failure. It classify A Fib itself is not dangerous. How often would count as constant? What can be happened if didn't take any medication for A Fib? I have a pacer too. The medication (not BB) didn't work. It makes me worst so I stopped it by myself. Any comments appreciate.
Thanks
Pika.
Thanks
Pika.
My cardio considers the MUGA scan a better indicator of EF than an echo... for what it's worth. A catheterization also provides a very good measure of EF... so I'm surprised the CCF doc said that the echo is the "gold standard".... my impression is that it is just the "standard"... Although I also found that an echo at CC or Mayo is a much more elaborate process than an echo on home turf. Going to a top med ctr really is the best... Upbeat, 24,000 pvcs in 24 hours and you are being told not to worry?? That does not sound right at all... I take a powerful bb despite having normal hr and bp because if I didn't I'd be in constant afib and experience heart failure... true the bb caused my hr to drop so I needed a pacer inserted to keep the hr up, but that was a small price to pay, and it turned out that the pacer has been a help with the arrhythmia anyway. Good luck to you two!
I too feel that I have been unable to ascertain a definite diagnosis from my medical providers for my ongoing symptoms which have spanned 22 years!!
It's always the same thing, it's benign, they are PVCs!
My first and only cardiologist, 12 years ago, said the only treatment for high frequency PVCs would be beta-blockers but that in an individual with normal BP and heart "rate", the BB probably wouldn't do anything for the frequency of PVCs and could make the PVCs worse. He didn't recommend them. I trust that information very much. I think that is correct information, is it not?
But my current MD prescribed BBs because recently a 48hr holter showed 24,000+ PVCs per day. Since then, they have progressed to constant bigeminy, gone away, and now come back with couplets and NSVT. During the bigeminy, I requested a stress echo, and I think it was with a raised eyebrow, that they scheduled it.
I had the stress echo done , and they WOULD NOT provide the EF or measurement of LV wall, only saying it was "NORMAL". When I asked for those numbers, they said since it was NORMAL, there was no reason to investigate further. I am now left wondering whether I should get a second opinion to read a NORMAL test, and thereby chase butterflies, or accept their findings. I could spend that money on a lot of other very necessary things instead of another normal report.
Why shouldn't I accept the findings? Why shouldn't you? Why shouldn't we all? I guess because there are still questions! I too have done extensive research on medline--www.nlm.nih.gov and found research articles related to high frequency PVCs as a possible cause to enlarged left ventrical, or onset of more serious arrhythmias. I have even met two people on this forum who had high frequency PVCs and developed a cardiomyopathy, so I would think my concerns are valid. But they have not been treated that way. PVCs are benign, can't I get that through my thick skull. smiles.
My point is, I really do wish you success both in finding the answers you seek and with your endeavors to become a medical provider. But please remember your experiences as a patient, and then provide as much compassion and reassurance to your own patients as you possibly can. Good luck.
It's always the same thing, it's benign, they are PVCs!
My first and only cardiologist, 12 years ago, said the only treatment for high frequency PVCs would be beta-blockers but that in an individual with normal BP and heart "rate", the BB probably wouldn't do anything for the frequency of PVCs and could make the PVCs worse. He didn't recommend them. I trust that information very much. I think that is correct information, is it not?
But my current MD prescribed BBs because recently a 48hr holter showed 24,000+ PVCs per day. Since then, they have progressed to constant bigeminy, gone away, and now come back with couplets and NSVT. During the bigeminy, I requested a stress echo, and I think it was with a raised eyebrow, that they scheduled it.
I had the stress echo done , and they WOULD NOT provide the EF or measurement of LV wall, only saying it was "NORMAL". When I asked for those numbers, they said since it was NORMAL, there was no reason to investigate further. I am now left wondering whether I should get a second opinion to read a NORMAL test, and thereby chase butterflies, or accept their findings. I could spend that money on a lot of other very necessary things instead of another normal report.
Why shouldn't I accept the findings? Why shouldn't you? Why shouldn't we all? I guess because there are still questions! I too have done extensive research on medline--www.nlm.nih.gov and found research articles related to high frequency PVCs as a possible cause to enlarged left ventrical, or onset of more serious arrhythmias. I have even met two people on this forum who had high frequency PVCs and developed a cardiomyopathy, so I would think my concerns are valid. But they have not been treated that way. PVCs are benign, can't I get that through my thick skull. smiles.
My point is, I really do wish you success both in finding the answers you seek and with your endeavors to become a medical provider. But please remember your experiences as a patient, and then provide as much compassion and reassurance to your own patients as you possibly can. Good luck.
I also forgot to mention that, this past year, I also began to experience episodes of indigestion, dysphagia, and hematochezia. These symptoms lead to a referral by my family practice physician for a more invasive examination by a gastroenterologist, approximately two months ago. The gastroenterologist performed an endoscopy (Diagnosis: Grade III GERD) and a colonscopy (Diagnosis: Two stomach ulcers). In consideration of these findings, I feel that my ability to ascertain a definitive diagnosis from a physician, besides the results received from my gastroenterologist, with respect to my aforementioned symptoms has been unsuccessful. I realize that I was informed, after the my arteriogram, by the cardiologist that my heart was fine and I have also been informed by several other cardiologist that an echocardiogram is not 100% sensitive or specific and that the results of the tests are highly weighed on the skill, experience and overall ability of the physician interpreting the echocardiogram. But, in my research concerning the topic I found some articles that I think are relevant to my above post with respect to potential adverse effects of amphetamines/catecholamines on the heart:
(1)Breggin, Peter R. (Director, International Center for the Study of Psychiatry and Psychology [ICSPP]). Psychostimulants in the treatment of children diagnosed with ADHD: Risks and mechanism of action. International Journal of Risk & Safety in Medicine 12 (1999) 3
(1)Breggin, Peter R. (Director, International Center for the Study of Psychiatry and Psychology [ICSPP]). Psychostimulants in the treatment of children diagnosed with ADHD: Risks and mechanism of action. International Journal of Risk & Safety in Medicine 12 (1999) 3
MEDICAL PROFESSIONAL
(1)Isn't the echo considered the
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